Expert Perspectives on the Use of Escitalopram in the Management of Depression and Anxiety Disorders in Indian Settings

Abstract

Background:  Though there are several studies on the efficacy of escitalopram in the management of depression and anxiety disorders, there is a dearth of studies among clinicians regarding their perspectives. This study assesses clinician preferences for escitalopram across various psychiatric conditions among psychiatrists practicing in Indian settings. Methods: The cross-sectional study utilized a 23-item questionnaire to gather expert opinion on the management of depression and other psychiatric comorbidities among psychiatrists in India. The study assessed the clinicians' perspectives, clinical observations, preferences, and experiences with escitalopram in the routine management of mental disorders. Descriptive statistics were used to analyze the data. Graphs and pie charts were generated using Microsoft Excel 2013 (version 16.0.13901.20400) to visually depict these variable distributions. Results: A total of 458 psychiatrists participated in the study. Approximately 71% identified generalized anxiety disorder (GAD) as the most common psychiatric comorbidity among patients with depression. About 73% of participants preferred escitalopram for treating major depressive disorder (MDD), and 92% considered it their first-line treatment for managing depression. Nearly 60% of respondents selected escitalopram as their first-choice antidepressant for social anxiety disorder. In terms of selective serotonin reuptake inhibitor (SSRI)-related side effects, 31% reported dry mouth as the most common adverse event, followed by gastrointestinal (GI) issues (29%). Around 78% favored escitalopram for patients with GAD who experienced increased sedation and dry mouth from paroxetine. Additionally, approximately 71% preferred escitalopram for cases of severe depression with suicidal attempts, while 74% recommended it for treating post-psychotic depression. Conclusion: This study confirms escitalopram as the leading first-line antidepressant, with most of the clinicians preferring it for depression. It highlights strong consensus on SSRI efficacy, common side effects, and treatment choices in complex cases.